title: Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation.
abstract: OBJECTIVE
  To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT).
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Outpatient rehabilitation clinics.
  
  
  METHODS
  A cohort of outpatients with stroke (N=55).
  
  
  METHODS
  Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks.
  
  
  METHODS
  Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score.
  
  
  RESULTS
  Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272).
  
  
  CONCLUSIONS
  The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings.
authors.affiliation: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Taiwan Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-wei
authors.initials: YW
authors.lastname: Hsieh
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Keh-chung
authors.initials: KC
authors.lastname: Lin
authors.affiliation: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Taiwan Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan. Electronic address: cywu@mail.cgu.edu.tw.
authors.forename: Ching-yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hen-yu
authors.initials: HY
authors.lastname: Lien
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jean-lon
authors.initials: JL
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-chi
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan.
authors.forename: Wei-han
authors.initials: WH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012371:Robotics; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: AOU; BBT; Box and Block Test; FMA; Fugl-Meyer Assessment; MAL; Motor Activity Log; Prognosis; QOM; RT; Rehabilitation; Stroke; VIF; amount of use; quality of movement; robot-assisted therapy; variance inflation factor